By John C. Wolf, D.O.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

ATHLETES CAN STILL EXCEL WHEN TREATED FOR HIGH BLOOD PRESSURE

Question: I've had my blood pressure checked several times, and it was high. I play basketball and do other things that involve vigorous physical activity. I've been dizzy and felt my heart fluttering several times lately when I've been playing hard. I haven't taken any medicine for my blood pressure because I'm afraid that it will cause problems with my performance on the court and in the bedroom. Do you think my blood pressure could be causing the dizziness and heart fluttering?

Answer: Blood pressure is reported as two numbers. The higher one, what we doctors call the systolic pressure, is the pressure in the arteries as the heart is contracting most forcefully. The lower number, the diastolic pressure, is the pressure when the heart is relaxing and filling again in preparation for the next "pressure" contraction.

The definition of high blood pressure (HBP) that I like is any pressure that is associated with an increased risk of health problems -- typically heart, kidney or circulatory disorders. Readings need to be taken on three different occasions when the person is seated and at physical -- and emotional -- rest. Systolic values over 120 and diastolic values over 80 have slightly increased health risks associated with them. Values greater than 140/90 are usually considered "high" because intervention has been proven to reduce the risks associated with these pressures. Values of 160/100 or more suggest that more aggressive initial treatment may be needed.

About 20 percent of adults have HBP, and the incidence increases with age. Of those with blood pressure problems, about 39 percent are unaware that they have the condition and only 16 percent are receiving adequate treatment to keep their pressure down where it should be. So, if you've actually had three high pressure readings, you would fall into that undesirable category of those with HBP who are not receiving adequate treatment.

Blood pressure can be elevated for a number of reasons but more than 90 percent of cases result from what we doctors call "essential hypertension." This is a fancy label to indicate that we don't really know the cause. Any treatment method that reduces blood pressure to the normal level will reduce the risks associated with essential hypertension.

The risk from untreated HBP is much greater than the risk from blood pressure medicine, however, undesirable side effects can happen. Interference with athletic and sexual functioning, the concerns you mentioned, are among them. Fortunately, it's usually possible to find a medicine or combination of medicines that along with sensible diet and exercise programs, will bring the pressure down to normal without side effects.

It is hard to say if your blood pressure has directly caused the dizziness and heart fluttering you've experienced while playing basketball. Typically HBP causes no obvious symptoms -- BUT -- it can. Therefore, I'd suggest that you see your doctor. Talk about your symptoms and also about your concerns for continued good athletic and sexual performance.

"Family Medicine" is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701. Past columns are available online at http://www.FamilyMedicineNews.org.